Aimee Howard Foundation: Empowering Young Minds Through Accessible Therapy

About you

How we get in touch, and where you practise.

Full name *

Email address *

Phone number *

Where are you based?

Practice name (if applicable)

Website

Credentials

We verify registration with your professional body before matching any clients.

Regulatory body

Health Professions Council of South AfricaSouth African Council for Social Service ProfessionsOther

If other, which regulatory body?

Registration number *

Years of experience

Qualification(s) *

What you can offer

This is how we match you with young people we are supporting.

What types of sessions can you provide?

In personOnline

Are you able to offer pro bono sessions?

YesNo

Are you able to offer discounted sessions?

YesNo

Standard session price

Discounted price

How many foundation sessions could you take per month?

Session length

Preferred frequency

WeeklyEvery second weekMonthlyFlexible

Are you willing to take on:

short-term cases (e.g., 6–12 sessions)long-term cases

Are you currently open to new patients?

YesNo

Typical wait time

ImmediatelyWithin 1 week1–2 weeks2+ weeks

Expertise and risk

Many of the young people we support are in crisis, so this section matters.

Areas of expertise

AnxietyDepressionTrauma / PTSDSuicide ideation / crisisSubstance abuseAdolescents / young adultsGrief & lossOther

Other areas of expertise

Languages spoken

EnglishAfrikaansisiXhosaZuluOther

What other languages can you provide therapy in?

Are you comfortable working with high-risk clients?

YesNo

Do you have protocols for crisis situations?

YesNo

Do you refer to hospitals or emergency services when necessary?

YesNo

Consent and ethics

Please confirm the following before submitting.

Preferred communication method

EmailWhatsAppPhone

I confirm I am registered and in good standing with my professional body *I agree to adhere to ethical and confidentiality standards *I consent to being listed in the foundation’s therapist network *

Step 1 of 5

Become a Partner Therapist

About you

Credentials

What you can offer

Expertise and risk

Consent and ethics